COMMUNITY COLLEGE DISTRICT 536 NPI 1679758387

NPI Information

NPI: 1679758387
Provider Name: COMMUNITY COLLEGE DISTRICT 536

Doing Business As: LEWIS & CLARK FAMILY HEALTH CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
5800 GODFREY RD
FOBES 1525
GODFREY, IL
ZIP 62035
Phone: (618) 468-6800
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COMMUNITY COLLEGE DISTRICT 536 is a family nurse practitioner in Godfrey, IL. COMMUNITY COLLEGE DISTRICT 536 NPI is 1679758387. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lewis & Clark Family Health Clinic.

The provider's business location address is:

5800 GODFREY RD
FOBES 1525
GODFREY, IL
ZIP 62035-426
Phone: (618) 468-6800

The provider's authorized official is Dale Chapman .
The authorized official title is President and has the following contact phone number (618) 468-4440.

The enumeration date for this NPI number is 1/2/2008 and was last updated on 2/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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